Development and Psychometric Testing of the Bimanual Assessment Measure for People With Chronic Stroke

Importance: Few tools are available to assess bimanual deficits after stroke. Objective: To develop the Bimanual Assessment Measure (BAM), which assesses a person’s hand coordination in both preferred and prestroke roles (i.e., stabilizer or manipulator). Design: Development and psychometric testing of the BAM. Setting: Research laboratory. Participants: People with chronic stroke (n 5 24), age-matched controls (n 5 23), and occupational therapists (n 5 40). Outcomes and Measures: We assessed the BAM’s internal consistency, reliability, and face and known-groups validity. Results: Items were selected as meaningful tasks that represented a range of bimanual coordination requirements (e.g., symmetrical forces and timing, asymmetrical forces and timing, time-limited reactive movement). Focus groups of people with stroke and occupational therapists provided input into BAM development. The BAM was found to have excellent reliability and internal consistency and face and known-groups validity. Conclusions and Relevance: The BAM is a valid, reliable measure for people with chronic stroke that identifies bimanual coordination deficits beyond unimanual impairments and the potential capacity for people to return to prestroke hand roles (i.e., as a manipulator).